[Question #10396] Unprotected Oral

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23 months ago
Hi Drs., I wanted to let you know I appreciate the work you do on this forum, and I have read a lot of the threads with similar questions as to mine. I received unprotected oral sex from a Trans Person that I met at a bar on Saturday. I am married and my wife was out of town. Total encounter lasted about 10 mins. I am experiencing guilt and anxiety from this moment of weakness. I do not know this person's history or STI/STD statuses. I am planning to get tested at 4 weeks, or when symptoms arise. I've read similar threads where the Drs have indicated that risk for this activity can be considered low but I would like some opinions on how I have approached. According to other questions & answers on the site I can deduce that HIV risk is essentially 0, HSV 2 is very low ( I already have HSV 1), syphilis is rare I considered this risk low, chlamydia is not happy living in oral cavity so I have considered that low risk. The real risks I feel (determined from previous threads/questions) is gonorrhea and NGU. I have not been experiencing any symptoms but am only 72 hours out. I did get with a telehealth clinic and they proactively prescribed a combo of Metronidazole (1 large pill ~ 1G or 500mg), Suprax (4 pills all at once, 400mg each not sure), and Doxycycline 100mg 2x daily for 7 days. I took all of this yesterday, and am continuing the doxy over the week. The telehealth provider was very confident this would prevent and or eradicate any bacterial STI (chlamydia, gonorrhea,  syphilis) from this encounter. My question(s) for you are 1) do you agree with my assessment of the risks associated with this event, and are there any STDs/STIs that I am missing? 2) Do you agree with the proactive regiment prescribed, and do you believe this will resolve any infection? 3) When do you believe I will be "in the clear" to have sex with my wife? 4) Should I get tested after the antibiotics?
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Edward W. Hook M.D.
23 months ago
Welcome to our Forum and thanks for your questions.  Thanks as well for reviewing similar questions on the Forum.  We leave them available so that they can be used in just the manner that you have.  I agree with your assessments and will provide specific comments below. 

1) do you agree with my assessment of the risks associated with this event, and are there any STDs/STIs that I am missing? 
Your assessment is right on target.  I agree completely and see no STIS that might have been missed.

2) Do you agree with the proactive regiment prescribed, and do you believe this will resolve any infection? 
You risk is so low that if you were not so anxious I might have suggested you simply watch and wait.  The treatment you have taken/started however would certainly prevent any of the STIs you mention- gonorrhea, chlamydia, syphilis, NGU and probably mycoplasma genitalium (which is an occasional cause of persisting NGU in men but is not known to be transmitted through receipt of oral sex)

3) When do you believe I will be "in the clear" to have sex with my wife? 
I see no reason to abstain from unprotected intercourse with your wife at this time.

4) Should I get tested after the antibiotics?
This, of course, is a personal choice but I probably would not bother unless some sort of symptom occurs.

I hope this information is helpful.  Thanks again for reviewing the information on the Forum.  EWH
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23 months ago
Thank you for the thoughtful and concise response Dr. Hook.